Seizures, Sleep, Snoring, and Side Effects: What’s the big deal?

Headshot of Laura Speltz. - Clinician's Corner

by Laura Speltz, M.D., Pediatric Neurologist

Question: When children are diagnosed with new-onset seizures, parents often ask, “Is there anything I can do to prevent my child’s seizures?”

Seizures and Sleep

As a pediatric neurologist, I always take the opportunity to discuss the intimate relationship between sleep and seizures. I cannot overemphasize the importance of good sleep hygiene. Consider the following: 

  • Approximately 1 in 3 patients who have epilepsy will have seizures that occur during sleep.
  • Specific types of seizures may occur more frequently in sleep.
  • Several pediatric epilepsy syndromes, such as Benign Epilepsy with Central Temporal Spikes, have a well-recognized relationship with patient’s sleep-wake cycles.

Regardless of the underlying cause, nocturnal seizures can lead to fragmented, poor quality sleep. Daytime fatigue, in turn, can affect your child’s mood, cognition, and can contribute significantly to both parental and patient anxiety about seizures.

Seizures and Sleep Deprivation

Have you ever wondered why your neurologist insists on a sleep-deprived EEG? We know that sleep deprivation can activate the abnormal electrical activity in your child’s brain that provokes seizures. Maybe you have noticed an increase in seizures after a rough night’s sleep, an illness, or a family holiday. This is because sleep deprivation lowers your child’s seizure threshold and makes them more vulnerable to breakthrough seizures. Seizures may also appear more intense or have an atypical appearance if a child is sleep deprived.

Seizures and Sleep Disorders

Many pediatric patients who have epilepsy also have other medical conditions that may predispose them to sleep disorders such as central or obstructive sleep apnea, restless leg syndrome and insomnia. Sometimes it is difficult to determine if the seizures are the cause of a child’s poor sleep, or if poor sleep is exacerbating the child’s epilepsy. Working with a team to sort out the answers can be critical to achieving optimal seizure control. If indicated, a sleep specialist may order an overnight sleep study (a polysomnogram) with a concurrent EEG to help clarify the relationship between your child’s sleep and his or her seizures.

Seizures and Medication Side Effects

Sedation is one of the most common side effects of the medications we prescribe to control seizures. This is especially true if your child needs more than one medication to treat epilepsy. Conversely, a smaller group of children can actually experience hyperactivity and insomnia as a consequence of their treatment. Working with your neurologist to find the right medication for your child will help minimize the impact of medications on your child’s sleep and daytime alertness. Sleep experts can help identify any behavioral patterns that are interfering with your child’s sleep. Your neurologist or sleep specialist may also suggest medications and/or natural supplements to help your child have more restful sleep.

Conclusion: Yes, there are things you can do to help improve your child’s seizure control; getting a good night’s sleep is one of them. Work with your child’s medical team and hopefully everyone will rest easier.